Payer Relations Manager: Impactful Health Plan Partnerships

Alt; United States; Remote; USD 90,000 - 130,000; Full time

Benefits offered by this job

Competitive salary

Comprehensive health insurance, dental

Flexible time off policy

Opportunity for growth

Collaborative team valuing innovation

Job summary

Adaptive Home Health in the United States is seeking a Payer Relations Manager to own relationships with commercial and government health plans, secure workable contracts, resolve access or payment issues, and provide leadership with clear payer performance data.

You will collaborate with revenue cycle, credentialing, clinical operations, and legal to improve contract terms, monitor denials, accelerate payments, and drive process improvements across the organization.

Qualifications

• Bachelor's degree or equivalent experience in healthcare administration, business, finance, or related field.
• 3+ years in payer relations, managed care contracting, revenue cycle, or reimbursement analysis, with direct work with health plans on contract, claims, or payment issues.
• Working knowledge of reimbursement methods, payer contracts, claims workflows, and the drivers of denials and underpayments.
• Ability to analyze financial and operational data and turn it into clear, practical recommendations.
• Strong negotiation, relationship management, and project management skills.

Responsibilities

• Serve as the primary relationship owner and escalation contact for assigned health plans.
• Support contract negotiations and renewals with analysis of rates, terms, volume, and financial impact. Track renewal dates, notice deadlines, and rate changes.
• Partner with revenue cycle to resolve recurring denials, underpayments, payment delays, and authorization issues, and drive process changes that prevent them from recurring.
• Monitor payer performance, including contract compliance, denial rates, AR aging, and escalation trends, and report findings and recommendations to leadership.
• Evaluate network participation opportunities and payer changes that affect patient access or financial performance.
• Coordinate with credentialing and enrollment on participation issues, and with legal and compliance on contract language and disputes.
• Communicate material payer policy and contract changes to affected teams.

Skills

Negotiation

Relationship management

Project management

Data analysis

Communication

Education

Bachelor's degree in healthcare administration, business, finance, or related field

Equivalent experience

Tools

Contract management tools

Claims analysis tools

Revenue cycle reporting tools

Job description

Adaptive Home Health in the United States is seeking a Payer Relations Manager to own relationships with commercial and government health plans, secure workable contracts, resolve access or payment issues, and provide leadership with clear payer performance data.

You will collaborate with revenue cycle, credentialing, clinical operations, and legal to improve contract terms, monitor denials, accelerate payments, and drive process improvements across the organization.